Patient Access Spec III - WMCG - Augusta Georgia

Patient Access Specialist III

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

The Patient Access Specialist III is responsible for scheduling outpatient procedures, gathering patient, guarantor, and insurance information, and entering the information in the health information system. The Patient Access Specialist III Schedistrar I manages scheduling requests from both patients and physician offices via phone, fax, paper requisition, and other acceptable forms of communication. The Patient Access Specialist III also provides visit-specific information to patients in preparation for their scheduled services and answers and triages patient questions and requests.

Changing business needs can necessitate changes in work responsibilities.

• Schedule outpatient procedures for departments within the sphere of responsibility.
• Perform registration functions including gathering basic demographic, guarantor, and insurance information during a single phone call in order to reduce wait times and simplify the check-in process.
• Enters all patient information into the registration system.
• Obtains all necessary signatures and is knowledgeable regarding any special forms that may be required by the patients third-party payer.
• Respond to both written and verbal request to have appointments rescheduled or canceled.
• Utilize medical terminology knowledge to determine if appointment request is consistent with the order.
• Inform patients and providers that a necessary authorization has not been obtained or that a procedure is being flagged as not medically necessary and that the patient may need to sign a non- covered services waiver upon arrival.
• Provide price estimates or triage requests to the appropriate resource when patients request information on their expected out-of-pocket expenses.
• Triage and process Appointment Requests adhering to department standards and communicating accurate, pertinent information to care providers and other members of the healthcare team.
• Identify, report, and prevent the creation of duplicate patient records, billing accounts and/or medical records to ensure patient safety and satisfaction. Efficiently use multiple information systems as required by departmental workflows.
• Answer basic Financial questions and refer patients to PFS when unsure how to respond to customer inquiries.
• Read, review and operationalize federal regulations regarding Advance Directives, COBRA, Medicare, Corporate Compliance, Joint Commission, OSHA and HIPAA; report safety and customer concerns to management.
• Read, review and operationalize new/revised policies/procedures via email, postings, mailings, voice mail and meetings.
• Utilize free time to ensure all activities benefit the department.
• Perform other duties and responsibilities as assigned.
• Reviews and monitors all order transcriptions and scanning.
• Assists with missing diagnostic and pathology reports.
• Assists in onboarding new team members.
• Assists with Coordination of Care Medical Record Requests.
• Floats to other locations as needed to provide needed support.
• The PAS III, Schedistrar I serves as a department preceptor and mentor and as such must:
• Maintain a registration accuracy rate or higher in the past 12 months.
• Maintain minimum productivity requirements.
• Has no corrective disciplinary action during the past twelve (12) months.
• Willing and able to function as a preceptor in the orientation of new patient access personnel and students.
• Maintain required certifications by obtaining necessary CEUs and submitting timely to certifying board.
• Budget/Financial:
• Attempts to collect the estimated self-pay balance of all inpatient, outpatient and ER accounts, at the earliest possible collection control point.
• Monitors in-house accounts and attempts to make financial arrangements with guarantors for payment of their self-pay balances in full and prior to discharge.
• Completes financial evaluation forms to document guarantors' income, expenses, assets and liabilities.
• Identifies those patients without adequate insurance coverage. Makes personal contact…